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How gallstones are treated

If you are interested in learning about the gallbladder - symptoms of gallstones, gall bladder problems and gall bladder treatments, you will find the following information helpful.

The gallbladder is a small sac located next to the liver and is used for storing bile, a greenish-brown liquid that plays a key role in digestion. When the chemical balance of the bile is upset, small particles begin to accumulate and grow into ‘gallstones’. This condition is also known as cholelithiasis.

This article on gallstones is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.


Gallstones are small, hard lumps of material composed of cholesterol, calcium carbonate (chalk) and calcium bilirubinate. They form in the gallbladder and come in a variety of shapes and sizes, ranging from fine gravel up to the size of a pea. Occasionally, however, the gallstones can combine to form a single ‘stone’ that fills the entire gall bladder.

Causes

Around 1 in 3 women, and 1 in 6 men will form gallstones during their lifetime. For reasons that are not fully understood, gallstones are more common if you’re overweight, have recently lost weight, or have ever been pregnant.

However, it’s clear that gallstones are usually a result of too much cholesterol in the bile, which can be caused by:

  • a high cholesterol diet
  • an excess of refined carbohydrates (like white bread and cakes)
  • using oral contraceptives
  • advancing age
  • genetic disorders (like hypercholesteroaemia)
  • liver disease

In rare cases, gallstones arise from excess bilirubin (a waste product from the breakdown of old red blood cells). This is more likely to be seen in patients suffering from cirrhosis of the liver, infection in the bile tube, and sickle cell anaemia.

Symptoms

Most people with gallstones do not even realise they have them. However, they can give rise to one or more of the following gallstone symptoms:

  • severe pain in the upper abdomen
  • fever caused by inflammation of the gallbladder (cholecystitis)
  • inflammation of the pancreas (pancreatitis)
  • infection of the bile duct (cholangitis)
  • nausea and vomiting
  • jaundice, if bile seeps into the bloodstream

The pain will worsen if a gallstone becomes lodged in the bile duct into the duodenum; a condition known as biliary colic. It often occurs half an hour after a fatty meal, when the level of cholesterol in the bile is greatest.

Diagnosis

Gallstones are often discovered by chance during diagnosis of unrelated conditions. They can be detected by blood tests, cholesterol tests, ultrasound scans, and X-rays.

Once found, doctors may perform a procedure known as a cholangiography. A dye is injected into the bloodstream or inserted directly into the bile ducts via a flexible fibre optic camera (an endoscope). X-ray images are then taken to reveal any blockages or abnormalities in the bile or pancreatic systems.

Treatment

Small stones

If the gallstones do not cause any symptoms, they are best left alone. However, if they cause inflammation of the gallbladder, blockage of the bile ducts, or move into the intestines, there are several treatment options:

Ursodeoxycholic acid – involves a course of medicine to dissolve the gallstones. However, successful treatment is not guaranteed and may take years.

Lithotripsy – is a method of concentrating ultrasonic shock waves on the gall stones to break them up into fragments. They may then pass naturally in the faeces.

Endoscopic retrograde cholangiopancreatolography (ERPC) – is carried out under a local anaesthetic and involves a flexible fibre optic camera being passed into your mouth, through the digestive system, and into your gall bladder. A heated wire is then passed through the endoscope and is used to widen the opening of the bile duct. The gallstones can be removed or left to pass into the intestine naturally.

Large stones

Gallstones surgery – does not just involve the removal of the gallstones, but of the gallbladder altogether. You do not need a gallbladder to digest food; it merely serves as a storage reservoir for bile between the liver (where it is made) and the gut. There are several techniques to remove the gallbladder:

  • Keyhole surgery (also known as a laparoscopic cholecystectomy) involves only small cuts to the abdomen and the aid of a special telescope.
  • Traditional surgery involves a larger incision and up to six weeks’ rest after the operation.
  • Other surgical procedures may be employed if a stone becomes stuck in the bile duct.

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